VR for Steroid Joint Injections - Feasibility

Virtual Reality Implementation for Pain and Anxiety Management During Intra-articular Glucocorticoid Injections in a Pediatric Rheumatology Clinic

The goal of the project is to implement virtual reality for pain and anxiety management for patients undergoing intra-articular glucocorticoid injections in the outpatient pediatric rheumatology clinic.

To assess feasibility of VR use in the clinic, 10 patients will be recruited to use VR during non-sedated intra-articular (IA) glucocorticoid injections. All patients will be offered our typical analgesia (LMX topical cream, freeze spray, lidocaine injection). Patients and caregivers will be asked to fill out pre-injection and post-injection surveys, and staff (rheumatology clinic nurses) will be asked for feedback regarding feasibility of VR in clinical workflows.

The specific aims of the study are to:

Aim 1: Assess the feasibility and efficacy of VR use to reduce pain in patients undergoing non-sedated IA glucocorticoid injections at Nationwide Children's Hospital

Inclusion Criteria:

1. rheumatology patients (5-17 years old) who are undergoing an IA glucocorticoid injection in the Nationwide Children's Rheumatology Clinic,
2. have a legal guardian present for patients less than 18 years old for the procedure (for informed consent), and
3. can communicate orally.

Exclusion Criteria:

1. any wounds that may interfere with study procedures,
2. vision, hearing, or cognitive/motor impairments preventing valid administration of study measures,
3. history of motion sickness, seizure disorder, dizziness, or migraine headaches precipitated by visual auras,
4. minors in foster care,
5. unable to communicate in English,
6. pregnant women, or
7. prisoners